What is Hep C?

Viral Hepatitis is an inflammation of the liver that results from infection with one or more of the Hepatitis Viruses. There are three primary forms of Viral Hepatitis in the US: Hepatitis A Virus (HAV), Hepatitis B Virus (HBV), and Hepatitis C Virus (HCV). All three hepatitis viruses present in acute infections, but Hepatitis A and B frequently clear without treatment interventions. Hepatitis C develops into a chronic infection in 80% of cases and, if left untreated, will likely result in chronic liver disease. The Hepatitis viruses are frequently asymptomatic, and often only show external symptoms when liver damage is present. Symptoms can include: jaundice (yellowing of skin and eyes), gray stools, fever, fatigue, and abdominal pain.

How Prevalent is Hepatitis C?

Hepatitis C is the most common blood-borne illness in the United States, affecting more people than the next 60 infectious diseases combined. The CDC estimates 30,500 new infections of Hepatitis C in 2014, with an estimated 2.7-3.9 million people living with a chronic infection. Massachusetts Department of Public Health estimates 200,000-300,000 are living with chronic Hepatitis C in Massachusetts. Hepatitis C prevalence is likely to be significantly higher given that between 60-70% of those infected with Hepatitis C are unaware of their status.

Who is at risk for Hepatitis C?

There are two primary populations at high risk for Hepatitis C:

Baby Boomers: People born between the years of 1945 and 1965 are five times more likely to be living with Hepatitis C then other adults. While the reason for this is not entirely understood, it is believed that most Baby Boomers contracted the virus between 1960-1980 when transmission of was at its peak. This may have occurred through contact with infected blood resulting from drug use, medical procedures prior to the implementation of universal precautions, or receiving blood or blood products prior to 1992 (before the supply was tested for HCV). The CDC recommends a one time HCV test for all people born between 1945-1965.

People who use drugs: The majority of new, acute infections of Hepatitis C are occurring in young adults who use drugs. People who use drugs are at elevated risk for Hepatitis C transmission, because of the risk of contact with infected blood. Sharing needles/injection drug works, waters, straws/bills, or pipes all place an individual at high risk of transmission. Prevent Hepatitis C by accessing new works, and never sharing.

For those living with Hepatitis C, it is also important not to share household items that could come in contact with blood, such as razors and toothbrushes.

How Can I Prevent Hepatitis C?

Hepatitis C can NOT be prevented with a vaccine. Not sharing any injection drug works is crucial to prevent the transmission of Hepatitis C Virus. It is important to note that Hepatitis C Virus can survive on dry inanimate surfaces for up to three weeks and suspended in a syringe for up to sixty days. Using barrier protection is also effective in preventing sexual transmission of Hepatitis C Virus if there is blood present. Although bleach is the most readily available defense for Hepatitis C disinfection, it is important to note that it is not 100% effective at destroying the Hepatitis C virus. Using new works, or not sharing your works is the best defense against Hepatitis C for people who inject drugs—bleach should remain the last option.

How is Hepatitis C Treated?

Hepatitis C has a cure that is 97-99% effective at achieving a Sustained Virologic Response (SVR) in an 8-12 week treatment regimen (SVR means that the virus is no longer detectable 12 weeks after treatment). This differs from the previous Interferon based treatments which only achieved SVR in 50-60% of cases and were associated with debilitating side effects such as hair loss, extreme fatigue, and excessive weight loss. The new treatments are highly effective with minimal side effects, and if taken early enough, can prevent the onset of severe liver complications.

Is Hepatitis C Treatment Covered by Insurance?

In August 2016, MassHealth, the Massachusetts State Medicaid program, removed liver fibrosis, sobriety, and prescriber restrictions that previously barred access to treatment coverage. If you receive insurance coverage through MassHealth, regardless of your plan, you can access treatment coverage. For more details, please see Hepatitis C: The State of Medicaid Access, a national summary report produced by the National Viral Hepatitis Roundtable and the Center for Health Law and Policy Innovation at Harvard Law School.

Looking for payer specific information? The Center for Health Law and Policy Innovation at Harvard Law School compiled a 2017 coverage guide detailing treatment costs for specific insurers. Access it here.